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Forms and Returns

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You can download the forms, returns and other formats used in leprosy disease surveillance. click on the blue color letters

Annual and Quarterly return formats

1. New Quarterly return format 2017 (NEW)

2. Annual Return 2016 (NEW)

3. Annual Return 2015

4. Quarterly return format 2016

5. Quarterly Contact Examination Return of Leprosy Patient at MOH

Special Investigation forms

6. Leprosy Relapse investigation form

District review formats

7. ALC DISTRICT REVIEW 2016 format

8. ALC HOSPITAL PRESENTATION 2016 format

Applications

9. WHO Fellow ship application form 2016

10. Personal Detail Form Fellowships 2016

Other formats

11. Satellite Clinic Information form

12. Satellite Clinic Information covering letter

13. Skin disease identification සමේ රෝග හදුනා ගනිමු

14. Re-referral from range PHI_Health staff to MOH Sinhala and Tamil

15. Referral back Referral to other clinics

Details
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Useful Links

Ministry of Health | Epidemiology Unit | NPTCCD (TB Control) | Health Education Bureau | Family Health Bureau | WHO | FAIRMED | ILEP Federation | International Leprosy Association

Contact us
Mail : Anti Leprosy Campaign, Welisara, Ragama | Tel : 0112958658 | Email - alcsrilanka@gmail.com | Central Leprosy Clinic NHSL - Tel : 0112696444 | Hendala Hospital - Tel : 0112930211



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